Provider Demographics
NPI:1386293793
Name:MARNELL, VUTINY THAMMA
Entity type:Individual
Prefix:
First Name:VUTINY
Middle Name:THAMMA
Last Name:MARNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17573 S PLUM TREE LN
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8087
Mailing Address - Country:US
Mailing Address - Phone:503-329-2067
Mailing Address - Fax:
Practice Address - Street 1:17573 S PLUM TREE LN
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-8087
Practice Address - Country:US
Practice Address - Phone:503-329-2067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider